
I left my job as a health insurance executive at Cigna after a crisis of conscience. It began in 2005, during a meeting convened by the chief executive to brief department heads on the company’s latest strategy: “consumerism.”
Marketing consultants created the term to persuade employers and policymakers to shift hundreds and, in many cases, thousands of dollars in health care costs onto consumers before insurance coverage kicks in. At the time, most Americans had relatively modest cost-sharing obligations — a $300 deductible, a $10 co-payment. “Consumerism” proponents contended that if patients had more skin in the game, they would be more prudent consumers of health care, and providers would lower their prices.
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